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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191593920
Report Date: 09/28/2023
Date Signed: 09/28/2023 02:54:11 PM


Document Has Been Signed on 09/28/2023 02:54 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754



FACILITY NAME:CLAREMONT PRESBYTERIAN CHURCH CHILDREN'S CENTERFACILITY NUMBER:
191593920
ADMINISTRATOR:SASKIA (SACHA) LORDFACILITY TYPE:
830
ADDRESS:1111 NO. MOUNTAINTELEPHONE:
(909) 626-6261
CITY:CLAREMONTSTATE: CAZIP CODE:
91711
CAPACITY:38CENSUS: 20DATE:
09/28/2023
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Sacha LordTIME COMPLETED:
02:55 PM
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On 9/28/2023 Licensing Program Analyst (LPA), Carolyn Tuba conducted an unannounced POC (plan of correction) inspection to clear the deficiency that was cited on 9/20/2023. A COVID risk assessment was conducted. LPA met with Director, Sacha Lord. LPA observed 20 children and 4 staff present at the facility during naptime.

During the visit LPA observed that cribs were moved out of the physical activity classroom (Infant Room). LPA consulted with the Director as she was not present during the initial annual visit. LPA went over Safe Sleep, Evacuation of Emergency Procedures with infant cribs and Supervision.

LPA cleared the deficiency on this date and provided a copy of the Licensing Report to the Director. LPA also issued POC clearance letter.

At this time, the facility is in compliance with California Code of Regulations Title 22. Therefore, no deficiencies are being cited.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the Director, Sacha Lord.

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SUPERVISOR'S NAME: Ana ChicoTELEPHONE: (323) 981-3374
LICENSING EVALUATOR NAME: Carolyn TubaTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:
DATE: 09/28/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/28/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
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